0001209191-12-036319.txt : 20120702
0001209191-12-036319.hdr.sgml : 20120702
20120702182428
ACCESSION NUMBER: 0001209191-12-036319
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120628
FILED AS OF DATE: 20120702
DATE AS OF CHANGE: 20120702
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SINGER KAREN
CENTRAL INDEX KEY: 0001265181
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-13117
FILM NUMBER: 12941567
MAIL ADDRESS:
STREET 1: 212 VACCARO DRIVE
CITY: CRESSKILL
STATE: NJ
ZIP: 07626
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: HealthWarehouse.com, Inc.
CENTRAL INDEX KEY: 0000754813
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912]
IRS NUMBER: 222413505
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7107 INDUSTRIAL ROAD
CITY: FLORENCE
STATE: KY
ZIP: 41042
BUSINESS PHONE: (513) 618-0911
MAIL ADDRESS:
STREET 1: 7107 INDUSTRIAL ROAD
CITY: FLORENCE
STATE: KY
ZIP: 41042
FORMER COMPANY:
FORMER CONFORMED NAME: HealthWarehouse, Inc.
DATE OF NAME CHANGE: 20090818
FORMER COMPANY:
FORMER CONFORMED NAME: CLACENDIX, INC.
DATE OF NAME CHANGE: 20080107
FORMER COMPANY:
FORMER CONFORMED NAME: ION NETWORKS INC
DATE OF NAME CHANGE: 19990413
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2012-06-28
0
0000754813
HealthWarehouse.com, Inc.
HEWA
0001265181
SINGER KAREN
212 VACCARO DRIVE
CRESSKILL
NJ
07626
0
0
1
0
Common Stock
2012-06-28
4
X
0
156250
1.60
A
156250
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
X
0
156250
1.60
A
312500
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
X
0
585808
3.00
A
898308
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
X
0
250000
2.90
A
1148303
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
S
0
38343
6.74
D
1109965
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
S
0
38343
6.74
D
1071622
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
S
0
251419
6.99
D
820203
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Common Stock
2012-06-28
4
S
0
103719
6.99
D
716484
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Warrant
2.90
2012-06-28
2012-06-28
4
X
0
250000
0.00
D
2011-09-02
2016-09-02
Common Stock
250000
0
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Warrant
1.60
2012-06-28
2012-06-28
4
X
0
156250
0.00
D
2009-12-15
2014-12-15
Common Stock
156250
0
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Warrant
1.60
2012-06-28
2012-06-28
4
X
0
156250
0.00
D
2010-05-03
2015-05-03
Common Stock
156250
0
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Series B Preferred Stock
0.00
2010-11-08
Common Stock
886895
886895
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
7% Senior Secured Convertible Promissory Note
0.00
2010-11-08
2012-12-31
Common Stock
292620
292620
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
Warrant
3.00
2012-06-28
2012-06-28
4
X
0
585808
0.00
D
2010-11-08
2015-11-08
Common Stock
585808
0
I
As the trustee to the Singer Children's Management Trust, the sole member of HWH Lending, LLC
The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein. This filing shall not be deemed an admission that the reporting person is, for purposes of Section 16 of the Act or otherwise, the beneficial owner of any equity securities covered by this filing.
The reporting person exercised a warrant to purchase 156,250 shares of common stock for the original conversion price of $1.60 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 117,907 shares of common stock to the reporting person.
The reporting person exercised a warrant to purchase 585,808 shares of common stock for the original conversion price of $3.00 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 334,389 shares of common stock to the reporting person.
The reporting person exercised a warrant to purchase 250,000 shares of common stock for the original conversion price of $2.90 per share. The reporting person paid the exercise price on a cashless basis, resulting in the company issuing 146,281 shares of common stock to the reporting person.
The reporting person holds 177,379 shares of Series B Preferred Stock. This amount includes 11,605 shares of Series B Preferred Stock received by the reporting person as a dividend for the year 2011. Each share of Series B Preferred Stock is immediately convertible into 5 shares of common stock.
N/A
The convertible note is immediately convertible into 58,524 shares of Series B Preferred Stock which amount includes a $53,048.39 interest payment on the convertible note received through May 8, 2012. Each share of Series B Preferred Stock is immediately convertible into 5 shares of common stock.
/s/ David J. Hoyt
Attorney-in-fact
2012-07-02